"It's not surprising that health care is becoming more important to employees as both the economy and labor market are declining," says Jack Bruner, national practice leader for Hewitt's health management practice.

Additionally, two-thirds of those surveyed say health benefits are either a primary reason for taking a job or a primary reason for remaining with a job. Other reasons listed include pay, retirement benefits, time off, and a flexible work schedule.

While a large majority, 88 percent of employees, say they are "somewhat or extremely comfortable" in researching, choosing, and maintaining their health insurance benefits, when it comes to going it alone, that number drops to 49 percent. Employees are still more comfortable getting their health insurance benefits through their employer rather than buying coverage in the private health insurance market. That doesn't mean consumers aren't looking for more choice. The survey reveals that employees are more confident in evaluating and selecting health plans than their employers realize.

The following health insurance enhancements are listed as priorities by both employees and employers:

• Options that allow employees to reduce the cost of coverage.
• Access to experts for advice on treatment options, doctors, and hospitals.
• Access to advocates to resolve disputes with health plans.
• Access to Internet data on medical conditions and treatments.
• Wider choice of health plans.

Employees rank each category nearly twice as important as employers. "It's interesting to see how employers are underestimating consumers' desire for more choices, flexibility, and control in making their health care decisions," says Bruner.

In the future, employers are expected to take advantage of consumer interest in more choice. As companies provide more options, they will begin to shift more of the cost onto the employees as well. The goal is to strike a balance between offering enough choice and holding down costs for older employees who may have difficulty paying higher out-of-pocket costs.

The majority of employees (84 percent) express interest in a customized health plan model that offers three different options for prescription drugs, physician office co-pays, and hospital deductibles.

Employees also believe that those who make reasonable efforts to manage an illness should receive improved benefits. Nearly two-thirds indicate they are willing to participate in a condition-management program provided by a health insurer if they are diagnosed with a chronic illness.